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Comparative Expected Value Analysis Study On Account and Financial Management Journal e-ISSN: 2456-3374 Volume 4 Issue 12 December- 2019, (Page No.-2048-2053) DOI: 10.33826/afmj/v4i12.01, I.F. - 4.614 © 2019, AFMJ Comparative Expected Value Analysis Study on Programs, Treatments, Medications and Products Reducing the Prevalence of Smoking, Alcoholism, Depression and Obesity in the United States S. Eric Anderson1, Morgan Redal2, Lorraine Abaro Thomas3, Ginny Sim4, Brooke Campbell5 1,2,3,4,5La Sierra University, Riverside California ABSTRACT: It was determined that medication provided the most value reducing the prevalence of smoking, alcoholism, and obesity, while exercise provided the most value treating depression. Value was determined by dividing treatment cost with success rate. Medication provided the most value reducing the prevalence of alcoholism followed by Alcoholics Anonymous, outpatient drug free treatment, , nicotine gum, nicotine patch, Chantix, nasal spray and nicotine inhaler. Acupuncture, lozenges, strips, sticks and laser therapy were not effective smoking cessation treatment options. Medication provided the most value in weight loss followed by liposuction, personal trainer and lap band. Exercise and meditation provided the most value reducing the prevalence of depression followed by medication, support groups and psychotherapy. KEYWORDS: Alcoholism, Depression, Expected Value Analysis, Obesity, Smoking Cessation INTRODUCTION Chronic conditions such as ischaemic heart disease and Ninety percent of the $3.5 billion spent on healthcare cancers (predominantly lung cancer) have caused health expenditures in the United States are for chronic and mental problems in regular smokers (1-4 cigarettes per day). A health conditions (Burtoff, 2017). Hafner (2016) reported study comparing regular smokers to non-smokers found that 21 million suffer from some type of addiction and only increased health risks due to long term smoking 10% of Americans suffering from addiction get the (Bjartveit&Tverdal, 2005). This leads to higher healthcare treatment they need for it. Also, twenty percent of costs for medications and treatments over an individual's Americans that suffer from depression resort to substance lifetime. Obesity alone, on average, can age an individual abuse (Addiction Statistics, 2019). Alcohol and drug twenty years. Obesity also causes chronic health conditions addiction costs the United States $600 billion every year. In (Strum, 2002). These conditions can cause a 36% increase the past 20 years over 700,000 Americans have died from a in spending for a hospital. An obese individual may also drug overdose. The Centers for Disease Control and cause a 77% increase in costs just for medications. Prevention (2018) reported that the cost of excessive alcohol A long term side effect of depression would be its increased use in the United States reached $249 billion in 2010.This mortality rate on those with Diabetes. A study found that study will conduct a comparative expected value analysis to major depression was significantly associated with mortality determine the effectiveness of programs, treatments, compared to minor depression which was nonsignificant medications and products reducing the prevalence of (Lin, et al., 2009). Results suggested that previously smoking, alcoholism, depression and obesity in the United diagnosed depression and diabetes patients have a States. significantly higher risk of mortality after recurrent Alcoholism, smoking, obesity and depression not only cause depression. health issues but can be costly over time. The prevalence of These risks to individuals not only negatively impact their this study reports the best treatments of each condition and health, but lead to costly treatments and medications. preventative treatments which were valued based on their Smoking, alcoholism, depression and obesity in the United success rate. The excessive consumption of alcohol has led States threaten the health long term wellbeing of patients. to fatality, disease and injury, alcohol related crimes and The purpose of this study was to determine the success rates motor vehicle accidents (Bouchery, E. E., et al., 2011). of programs used to treat these conditions to overall benefit Premature death due to alcoholism has been estimated on the affected individual. average to be 79,000 deaths annually. The cost alone in the United States back in 2006 for excessive drinking was about Alcoholism Program Costs and Success Rates $746 per individual. The cost for the 12step Alcoholics Anonymous program can be around a $250 donation,and the American Society of 2048 S. Eric Anderson1, AFMJ Volume 4 Issue 12 December 2019 “Determination of Company Profitability and Value of Banks in Indonesia Based on Risk Profile, Capital Structure, Corporate Governance and Asset Structure” Addiction Medicine (2015) reported that approximately 10% treatment of problems caused by excessive drinking (11%), of the people enjoy long term success in their recovery. law enforcement and other criminal justice expenses (10%) Outpatient drug-free programs cost $1,200 and 18% remain and losses from motor vehicle crashes related to excessive sober after five years (Juergens, 2019). alcohol use (5%). Therefore, the total cost of excessive alcohol consumption was $69.72 billion ($249 billion * .28) The price for medication to treat alcoholism (naltrexone) not including workplace productivity. According to the varies from $25 to $60 per month and the treatment typically Office of Management and Budget (2019) the excise tax lasts for three months for an average cost of around $150. revenue from alcoholic beverages amounted to $9.9 billion According to the National Institute of Alcohol Abuse and in 2017, which resulted in a net cost of $59.82 billion. Alcoholism around 20 – 25% of those receiving medication According to the Substance Abuse Mental Health Service and therapy remain sober after five years (Thomas, 2018). Agency (2017), 14.1 million adults ages 18 and older have Detox costs $2,200 on average and 17% remain sober after alcohol use disorder resulting in a$4,242 ($59.82 billion / five years (Juergens, 2019). Residential treatment costs 14.1 million) per capita cost for excessive alcohol use (not $3,100 and 21% remain sober after five years (Juergens, including workplace productivity). It was reported that 2019). Inpatient treatment costs $3,200 on average and 21% American’s spend on average $558 per year on alcohol remain sober after five years (Juergens, 2019). purchases (Bureau of Labor Statistics, 2019). Therefore, the The Centers for Disease Control and Prevention (2018) total cost per person (CPP) or savings would be $4,800 reported that the cost of excessive alcohol use in the United ($4,242 + $558). It was found that medication provided the States reached $249 billion in 2010. Seventy-two percent of most value treating alcoholism with an annual net benefit the costs resulted from losses in workplace productivity, (ANB) of $4,160. while the remaining 28% were for health care expenses for Programs SR Cost Cost/SR CPP ANB Medication 20% $128 $640 $4,800 $4,160 Alcoholics Anonymous 10% $250 $2,500 $4,800 $2,300 Outpatient Drug Free 18% $1200 $6,666 $4,800 -$1,866 Detox 17% $2200 $12,491 $4,800 -$7,691 Residential Treatment 21% $3100 $14,761 $4,800 -$9,961 Inpatient Treatment 21% $3200 $15,238 $4,800 -$10,438 Smoking Cessation Program Costs and Success Rates Zyban has a 16% success rate. The average cost of Nicotrol The average cost for a stop smoking hypnotherapy session is is $420 for 168 cartridges, which will last for 28 days if one about $85 per session or $340for a four session stop uses six cartridges per day (Ghosal, 2019) and a six-month smoking program (Thompson, 2011). Twenty percent of the supply would cost around $2,500. Nicotine inhalers have an participants in the hypnosis group were abstinent at 12 18% success rate after twelve months (Hialmarson, Nilsson, months compared with 14% in the behavioural group Sjostrom and Wiklund, 1997). A month's supply of nicotine (Carmody, 2008). Nicotine gum cost on average about $4.50 nasal spray purchased from an online retailer goes for $150, for 10 pieces of gum, the amount most people need to chew and a six-month supply could cost as much as $900. A daily to control nicotine withdrawal. After three months nicotine mouth spray typically has a 13.6% success rate after $405 ($4.50 * 90 days), most will be able to begin tapering one year (Tonnesen, Lauri, Perfect, Mann and Batra,2012). off the amount of gum they chew (Thompson, The Federal Drug Agency has ruled that lozenges, strips and 2011).Shiffman (2002) reported that only 8.4% in the OTC sticks that contain small pouches of tobacco for the mouth nicotine gum group were not smoking at the end of six are not smoking cessation aids. There’s no evidence that months. A month's supply of OTC nicotine patches these products can help a person quit smoking, but there is purchased from an online retailer is about $80 and roughly evidence that oral tobacco products like snuff and chewing $500 for a six month supply (includes shipping). Shiffman tobacco can cause cancer (Cancer.org, 2019).The average (2002) reported that only 9.2% of those using the OTC patch cost of acupuncture as a stop smoking technique ranged were not smoking after six months. from $50 to $100. However, this review did not find A 30-day supply of Chantix from an online retailer costs consistent evidence that acupuncture was an effective around $425 or around $1,275 for a three-month supply. smoking cessation technique. A laser therapy program costs There is currently no generic version of Chantix. Martin $349.This works like acupuncture, but instead of needles, it uses (2019) reported that Chantix had a 22% success rate (SR). A low-level lasers that won’t hurt the skin. Studies haven’t 90-day supply of a generic version of Zyban from an online confirmed that it works (Nazario, 2019).
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